Dr. Colin Banas is the Chief Medical Officer at DrFirst, a company focused on end-to-end medication management. Here's a summary of the key points from his interview:
Key Takeaways:
- DrFirst aims to get patients on therapy and keep them on therapy through frictionless medication management processes.
- The company uses data and AI to personalize patient experiences and improve medication adherence.
- DrFirst is focusing on optimizing the specialty medication experience, addressing challenges in prior authorization and transparency.
- Dr. Banas emphasizes the importance of augmented intelligence to assist clinicians and tackle administrative burdens.
- The company touches a quarter of all prescriptions in the United States, providing significant scale for impact.
Dr. Banas's journey into healthcare technology began when he co-founded the Office of Clinical Transformation at his previous hospital, aiming to improve the electronic medical record system. He later joined DrFirst to have a broader impact on medication management.
DrFirst uses data to measure the success of their interventions, tracking metrics such as adherence rates, time savings for healthcare providers, and improvements in patient safety. They're currently focused on addressing the growing complexity of specialty medications.
Looking ahead, Dr. Banas envisions using augmented intelligence to improve transparency and reduce administrative burdens in medication management, particularly for specialty medications.
About Dr. Colin Banas ----
Colin is an Internal Medicine Hospitalist and former Chief Medical Information Officer for VCU Health System in Richmond, Virginia. He has testified before the U.S. Senate and the Office of the National Coordinator (ONC) on health IT and the Meaningful Use program, and is a former Health IT Fellow for the ONC.
His interests center on the role of big data and analytics on patient outcomes and on novel forms of clinical decision support that are outside the realm of traditional rules and alerts, including real-time dashboarding and intuitive usability designs. He also helped spearhead the VCU effort to participate in the Open Notes initiative, where patients have access to their clinical documentation in real time.
In 2017, Colin received the HIMSS-AMDIS award for Physician Executive of the Year from his peers. He earned a bachelor’s degree from University of Virginia, his M.D. from Eastern Virginia Medical School, and a master’s in Healthcare Administration from Virginia Commonwealth University.
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Hello, and welcome to the glow up. Today I'm talking with Dr. Colin Banas of DrFirst. Dr. Colin, it's so great to see you today. Thanks for joining us.
Dr. Colin Banas:Oh, thanks for having me.
Nathan C:Amazing. So to kick us off, can you tell us a little bit about who you are and what you do at DrFirst?
Dr. Colin Banas:Oh, wow. so as you mentioned, I am the chief medical officer for DrFirst. So, most importantly, I'm an internal medicine physician by training. So for close to 20 years, I was actually a practicing hospitalist as well as the chief medical information officer for a large academic health system in the Mid Atlantic. did that for quite some time, as I mentioned, and then about five years ago, I had an opportunity arise where I could join DrFirst as their Chief Medical Officer, which is a really fun role. You know, it's actually pretty interesting coming from the academic, you know, clinical side over to the vendor space or the administrative business side. But I get to do a little bit of everything, as Chief Medical Officer, so there's a lot of subject matter expertise that I'm able to lend to the technical teams. I'm often doing a lot of speaking engagements, like we're doing here, a lot of speaking, podcast webinars, things like that, especially at trade shows, fireside chats and things like that. And then, you know, there's a fair amount of sales support too, right? convincing my other clinical, brethren that the solutions that DrFirst is able to provide in the medication management space are actually top notch and that you're missing out if you're not using us.
Nathan C:As a marketer, I'm very curious about how you get, to those conversations. But before, we jump into the tactics of it, I'm hoping you can just, dive into the problem space that you're working on over at DrFirst? what's that core problem that you're trying to solve for these, former colleagues of yours?
Dr. Colin Banas:Yeah. The core competency of the company is end to end medication management. So if you think about the lifecycle of a prescription from showing up at a doctor's office or provider's office to them making the prescribing decision to you getting that prescription filled and ultimately staying on therapy and then monitoring that success, that journey Dr. First has a piece of every single step. And so the problem space, if I had to distill it down is, Getting patients on and keeping them on therapy. That is the ultimate goal. That is where we are successful. That is where patients will succeed. And of course, as a clinician myself, I want to make this process, as frictionless and, almost as joyful as it can possibly be. so it's a tightrope, right? I'm walking regulatory requirements. But I'm also trying to improve the process, but ultimately the core of your question, getting a patient on therapy and keeping them on therapy.
Nathan C:Are you able to describe a way that DrFirst makes managing medications delightful? As a patient, you know, I have ADHD and ADHD medications are notoriously hard to manage from a patient's perspective. How does DrFirst, make this holistic view and success, more enjoyable, delightful.
Dr. Colin Banas:Yeah. So from the provider perspective, there are, it's little things, it's little things that remove the friction from the process. It's surfacing information and data at the right moment so that I know These are your prescriptions, this is what has not worked, this is what has worked. it's keeping me within regulatory, requirements without it making me chase extra clicks or extra screens. it's even convenience. You know, one of the cool things that I get to work on is our mobile prescribing. So, I can be at my kid's soccer game, you could contact me and say, I'm actually running low, or I'm about to, you know, enter the weekend. And my supply of something that is critical is about to run out. I can actually use my mobile device and make that prescription without ever picking up a phone, without ever logging back into a laptop or, you know, VPN back into the company, and also you on the patient side are going to get notified. Dr. Banas has just taken action. Click here to learn about it. If we can line you up with coupons or savings event, visit We'll do that too. And so, it's little things along the way to remove friction that actually make this, enjoyable. At least that's the vision and that's the hope.
Nathan C:So, we were introduced around the HLTH event, just recently in Vegas. One of the things that I noticed at the HLTH event was this idea that, Doctors? Payers, insurance agencies are all really feeling the pinch of there's not enough people to do all of the important health care work that we need to do. And in the past, there seemed to be this, model that the only place you could get care or connect with a doctor was in the doctor's office. And there were a number of reasons for this. It might be that only, you know, insurance companies only pay for doctor's visits. It might be that doctors only prefer face to face and there, there's all these differences. but at HLTH what I really started to hear was there is such an urgent need to address gaps in the system or just to address health care needs that. Everybody is interested in looking at technology, and especially AI, to see how technology can improve the care, can reach customers where they are, can, you know, be more real time, can be more communicative, can be more activated. And it almost seemed like there was this permission that people got, and there was this, Ownership, that each part of the supply chain was like, hey, we've got data, we want to contribute. And what I'm hearing from you is that you have data on this whole experience within medical application management, and you're using that information to supply context and data and even like regulatory, you know, needs in real time.
Dr. Colin Banas:I would have been happy to talk about, how we use
Nathan C:Okay, let's do it. So, how do you use, how do you activate, you know, what excites you about the data that you're able to contribute into this conversation? And, how does DrFirst sort of stand out in the way that you do that?
Dr. Colin Banas:yeah, you know, there's a lot of quotes that come to mind when you're hearing the excitement around this, you know, one of which is"you can't manage what you can't measure." And, the other fun one, Is"in God we trust everyone else must bring data." and I think that's true, right? And, at Dr first, as you mentioned, we do have a fair amount of data and we use that data to curate our solutions. one of the initiatives that we are taking on right now relates to the personalization of some of those messages that we were able to send our patients on behalf of the doctors. So the more I understand about you as a patient. Your social determinants of health, your zip code, your prior medication history, and your medication list. The better I can tailor that message directly to you, personalized to you, to provide you the appropriate education, the appropriate, activation. You used a great word there, right?
Nathan C:So, The Glow Up is very much a business podcast, and, you know, I love better user experiences as a path to great, products. how do you measure the impact, of the work that you're doing within medication management? Especially when, like you said, there are many players, many stakeholders, and it is a bit of a journey where you have to, get. There's a lot of challenges, in this space. You wouldn't be a tool if there weren't. But, how do you view and measure your success in this space?
Dr. Colin Banas:Yeah, it all comes down to data. So on the patient engagement side, adherence rates, right? we vigorously measure our interventions and whether or not they had an impact on that patient, picking up that medication and that patient staying on that medication. and then we figure out. With data, why was that successful? is it because we educated them? Is it because we provided a co pay assistance program face up? Was it because we were able to link them to other resources such as specialty medication hub services or things like that? On the hospital side or on the provider side, you can take something as routine as medication reconciliation. So for your listeners, every time you go to the doctor, they're supposed to Interview you, figure out what medications you are currently taking, and then make decisions about what to continue, what to stop, what to change. And then on the way out, hand you a list or, educate you and say, This is what you should be doing going forward. This is a miniature version of your care plan. Well, we have tools that make that process more efficient. We have tools that bring in more data to that interview process. We have AI tools that can bring that data over in such a way that the electronic record is able to consume it without people re keying or re typing. So in that instance, we're measuring clicks and keystrokes. and time savings. And then I turn around and I go back to the health system and I said, did you know after we implemented, after you implemented our tool, your pharmacy technicians were able to see 50 percent more patients during the shift, or your serious safety event rate related to medication error went down 25%. And these are numbers that I'm making up. These are real world numbers that we are getting from our partner clients. and actually publishing on in peer reviewed journals. So, it all comes down to data, it all comes down to measurement, and it also comes in engaging the stakeholder in saying, what is important to you, so that I know what the most appropriate thing is that we can be measuring.
Nathan C:50 percent more visits, 50 percent more patients seen is a pretty dramatic, stat that speaks both to the operational efficiencies, right, like what the team can do, but when we're talking about patient outcomes, that's 50 percent more patients, seen that day, which is not insignificant. Has there been, a data point or a learning that you've had in your time at Dr. First that has either changed, the way you, you know, that, that really impacted, the roadmap of the product, or that changed your understanding, of those, continuation of care dynamics in a notable way.
Dr. Colin Banas:I'll give you one from an industry perspective, it's the growth of specialty medications. It is, we're seeing an exponential growth in these highly specialized and highly effective And so, in order to be successful as a medication management company, you need to go to, you need to skate to where the puck is headed, and the puck is headed towards specialty. And so, we are very deep into optimizing the specialty experience. and that comes with a lot of, vagaries. you know, not all specialty medications are the same. Some of them are handled by your pharmacy benefit. Some of them are handled by your medical benefit. some of them require delivery to a doctor or to home for you to do the injection. Some of them you have to go to an infusion center. You know, it is a very complicated thing to navigate. and for a company that specializes in this, no pun intended, imagine how hard it is to keep up as a clinician, in terms of what are the rules, what is the sequence I need to go through here. And so, that's what we're, you know, you, you mentioned what data point altered the roadmap. It is the growth of specialty, specifically sent us, DrFirst, on a trajectory to solve And to make that experience joyful as well, as much as one can do. And so that means conquering prior authorization. That means conquering transparency, not only for the clinician, but also for the patient. you have better insight into the status of your pizza. delivery than you do in understanding where you stand on your specialty medication, right? That's insane. I got, you know, the pizza is in the oven. The pizza has been picked up. The pizza's on the way. I order, you know, one of these new specialty medications for a patient, and I might not know for days that it requires a prior auth or that the prior auth has been denied. there's all sorts of opportunities that we can conquer together. to make this, much more, appropriate, right? I don't want patients delayed therapy because of bureaucracy. And so this area is rife with opportunity. And it lends itself very well to AI and automation.
Nathan C:I just have to give that a moment that, right, like, we shouldn't be impacting care with bureaucracy, I think is a fantastic, mission for anybody who's trying to optimize, that healthcare space. So the show is called The Glow Up, right? And a glow up is a notable improvement, a breakthrough of sorts. I'm curious, what sort of glow up do you envision for your work at DrFirst in the next six months? What are the big goals and milestones you're working on right now?
Dr. Colin Banas:It is transparency, through Augmented intelligence. And I specifically use the word augmented intelligence. I'm actually, I hate the term artificial intelligence. I find it to be kind of off putting and a little bit almost creepy. Whereas the real vision for AI is to be this assistant. to sit at my shoulder, if you will, and help me do the work, so that I can be a better clinician. And right now, a lot of what AI is able to take on and what clinicians are comfortable with is tackling the administrative burden. And so I would say, The next six months to 12 months in the specialty space, we are glowing up in the application of AI in the administrative burden as it relates to medication management and specialty medications. and to me, that is super exciting because the trajectory of, of this augmented intelligence tools. is going through the roof right now, as is the rate of the use of specialty medications, as, and the frustration with the process is also going up. So again, you're back to my earlier comment, there is so much opportunity here for us in the next six months that we are avidly jumping on here at Dr. First.
Nathan C:I love how Specialty medication is kind of a challenge because it's taking, if I'm understanding correctly, like in a lot of cases, hyper targeted solutions for an individual, right? Some cancer treatments are like Targeted to your specific genes, if I understand correctly, right? And so, how do you both scale the production of these complex, personalized things, but then also how do you scale the communication, delivery, education of this, these very complex and and so forth? Potentially, each one is slightly different. Each one is targeted and unique. so there's this push pull of AI giving you the opportunity to personalize, and that personalization creating a whole lot of complexity, but then you can use the AI, to build it out. when, People hear AI will use your data for better experiences. I think a lot of them also hear Wait, what are you doing with my data? so the question is, how do you balance innovation with AI plus, regulatory concerns about data as well as just, your patients and consumers concerns about data? how do you balance all of those, concerns in innovation?
Dr. Colin Banas:it's about autonomy. It's about providing patients a level of autonomy in regards to their data. So a great example is for our patient engagement solution. You have the ability to opt out at any time, and it's as simple as, typing the word stop. we make it just as easy to get out. As it is to get in, similarly with other data solutions, patients have to give consent to the providers and then back to us in order for us to access that data on behalf of the provider. you're right, and I think this is part of the reason the interoperability journey is a little slower than it has been for those other industries that I rattled off. we need to tread carefully. This cannot be the wild, wild west when it comes to patient data sort of flying all over the ether. It has to ultimately remain in the control of the patient. there are very smart people working on this. being able to, opt in for certain use case scenarios, but opt out for others, takes time. You know, you might be very comfortable with your anonymized data. Going to a cancer registry because it's going to further the cancer, effort. But you might not want the pharmacist down the street to know your full medical history because it's none of their business, you know, in your mind. You know, there are levels and guardrails that are being put in place to give that autonomy back to the patient, if you will.
Nathan C:I heard so much at the HLTH event, this idea of Start with choice, right? Like, most of what patients want is a say in their care. And, you know, if you give people a choice, they typically will make the decisions that they, feel are best for them. Dr. Collin, I'm a little remiss. I usually love to like understand, the spark, the beginning of somebody's journey and innovation, and I feel like I skipped over this with you a little bit. What was the moment that, took your long standing, academic and clinical practice and got you interested in the business and technology side of it. how did your journey on this innovation side, begin?
Dr. Colin Banas:Yeah, you know, with a lot of Genesis stories, there's always a sensei or a mentor. very early on in my hospitalist career, I was, I don't want to use the word discontent, but I wasn't necessarily fulfilled. one of the things I did while I was a full time attending hospitalist, was pursuing my Master's of Health Administration. I figured, you know, can never go wrong getting more education. Let me understand how hospitals work. Let me understand the business of medicine. And actually from there, I started to get other opportunities within the four walls of the hospital. For a while, I was the medical director for care coordination, and I was in charge of utilization management. But the real turning point came in about 2005, 2006, when my really good friend, and ultimately my mentor, Who now works as the CHIO at Emory University, Alistair Erskine. he and I started what we called the Office of Clinical Transformation. And the reason we did so is because our health system had an electronic medical record since 1999. They were actually ahead of the curve. They had a full blown instance of Cerner. But there was no clinical input into it. It was just sort of like plopped upon the clinicians and there were no enhancements being made. The upgrades were falling behind and you know, it just so happened that he and I were interested in technology. and we said, you know what, We can do better. And so we actually started an informatics program at the university. and then ultimately that, you know, the leadership of that fell to me. I did that for another 10 plus years and then it started to get stale. And so there's actually two Genesis stories here, right? There is, how did I get into informatics in the first place? Right place, right time, interest, and a good mentor. And then, you know, about 2019, what else is out there? What's the next thing I can be doing? You know, 17, 18 years is a long time to be at one place. What's the next journey? How can I take all of this experience, from academic and administrative medicine and apply it somewhere else that might have an even bigger impact? our solutions touch, a quarter of all of the prescriptions in the United States. So in one way or another, we are touching a quarter of the prescriptions that are out there. That is scale. You mentioned scale before. intervening at that scale has a real opportunity to move the needle. And that's what keeps me excited here at DrFirst.
Nathan C:I am so glad I went back and asked that. Thank you. that's so amazing. I believe this is like the 15th episode of The Glow Up that we've recorded, and I am surprised, and so thankful that I believe this is the first time somebody's mentioned mentorship, specifically as, one of those jumping off points, and I could not Agree more, right? I'm in the tech space. my model for this, is when you are a subject matter expert and you also learn the business side, that's when you become really dangerous because you see the details, but you also know how it fits in the overall ecosystem. And for you to just sort of naturally be like, the administration side seems like a good thing to understand. I applaud that curiosity, and then, you know, that a mentor could not only sort of bring you into a new fields, but then eventually place you as a leader, in that space, within just a couple of years. It's, it's always impressive how, like, a passion project and a little bit of support, can, Belief, can be so amazing, for sparking new directions. Dr. Collin, you're working on some pretty big things and being able to, you know, touching a quarter of anything at the scale of healthcare is such an amazing, feat in itself, I'm curious how you think about success, and how will you know, that your work to make data, informatics, customer experience, user experiences better, how will you know that you've made it or succeeded on this mission,
Dr. Colin Banas:Oh man, how do you spike the football? you know, in healthcare, I'm not sure that you ever really can. obviously it's important to set goals along the way so that you can celebrate success, that you can re evaluate, re adjust, your roadmap going forward. I will say, you know, from a selfish point of view, I would love for DrFirst to be a household name. I really, really would. and we're getting there. Believe me, in my five years, actually almost six years now of being with the company, I think our recognition has grown, substantially. So that is, that is, you know, that, that, that's a metric of success and that's a little bit of, of ego, but it's still important, because I truly believe, in the, work that we're doing in the success stories that we're able to make on behalf of our clinicians and patients. I will say that along the way, the way to measure success, and again, incremental, would be in things like satisfaction. You know, Let me interview the clinicians using our solutions. let me have metrics around customer satisfaction. Let me have metrics around patient satisfaction. But ultimately, you know, you want to set the bar very high. And it would be, you know, a moonshot goal would be 100 percent of appropriate prescriptions are being 100 percent adhered to when appropriate. you know, it's things like that where you really need to think, about what, what do we as an industry want to measure as success, and how can my little piece of the care journey contribute to that? And so there's lots of things that we could be measuring along the way, but, it's gotta be incremental and it's gotta be data driven.
Nathan C:You said some things that I think are really worth, like, turning back to. One, when you're working on something as big as a quarter of all prescriptions in the U. S., you have to set your own rules. Goals and, you know, definitions of success. You cannot, like, look at an ecosystem that big and distill out, did we do it or not? Without, you know, putting your own values and markers along the way, right? And so, I think, you know, trying to solve a very big problem is really about checking off those smaller boxes over and over again, until you reach, that infinite, impossible, 100%. Especially in a thing like healthcare, like, there is no final goal. It's always going to be innovating. It's always going to be growing. And, to your larger goal, I have to say, there is a ton of opportunity to become the household name for medication management that's based on delight and value received, rather than the typical, We'll save you something on your prescriptions and Maybe that whole experience of saving money on your prescriptions is totally awful. So I think there's, there's a lot of opportunity to become a beloved household name, in this, medication management space
Dr. Colin Banas:I think if you build it correctly, they will come. And that's, we are on a journey. We are marching
Nathan C:I love it. So on this journey, one of the things that we always make time for is just to ask, is there anything that you're looking for, hoping to engage people around? sometimes this is like networks. you mentioned things that you're looking to learn. do you have a call to action or, anything that you're hoping, anybody that you're hoping to connect with?
Dr. Colin Banas:I'm always eager to learn. you probably could tell. I stayed in school a long time and then kept, kept, kept on going. This is a complicated ecosystem, believe it or not. Healthcare, particularly healthcare in our country, has a lot of players and a lot of players behind the scenes that, quite frankly, a lot of us don't fully understand. And so, if nothing else, I'm always looking to connect. with a way to further my education and then to pass that on. You know, I view one of my roles in the company is also as an educator. I can educate on the clinician experience. You know, we're all patients at one time or another can educate on that. And then, I do feel uniquely positioned in understanding the regulatory space and the administrative space. And so, I'm always looking to connect with leaders and thought leadership. in those, particular areas as well. So call to action, you know, connect with me and help me learn more because I am, avid for it.
Nathan C:Amazing. Well, Dr. Colin Banas of DrFirst. It has been such a delight for me to learn with you. this space of, innovation within these, traditional and, gigantic industries of healthcare, pharmacy, medication management, is such a delight for me. Juicy and multifaceted problem to be solving, and it warms my heart over here at Awesome Future to hear you talking so much about delightful experiences, AI, and data to empower clinicians. to build more human connections, around healthcare conversations, instead of filling out the same form seven times at each visit. amazing work. Thank you for sharing your journey and innovation with us on the Glow Up
Dr. Colin Banas:oh, thank you for having me.